ICD-10 Coding for Polio(A80.9, B91, G14)
Complete ICD-10-CM coding and documentation guide for Polio. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Polio
A80Primary Range
Acute poliomyelitis
This range includes all forms of acute poliomyelitis, which is the primary condition of interest.
Postpolio syndrome
This range is used for coding postpolio syndrome, a specific late effect of poliomyelitis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A80.9 | Acute poliomyelitis, unspecified | Use when acute poliomyelitis is diagnosed with clinical and laboratory confirmation. |
|
| B91 | Sequelae of poliomyelitis | Use for patients with long-term effects of polio, such as limb atrophy. |
|
| G14 | Postpolio syndrome | Use when postpolio syndrome is diagnosed with new symptoms in a polio survivor. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for acute poliomyelitis
Essential facts and insights about Polio
Primary ICD-10-CM Codes for polio
Decision Criteria
clinical Criteria
- Presence of acute flaccid paralysis and lab confirmation
Applicable To
- Acute paralytic poliomyelitis
Excludes
- Sequelae of poliomyelitis (B91)
Clinical Validation Requirements
- Acute flaccid paralysis
- CSF pleocytosis
- Positive stool PCR for poliovirus
Code-Specific Risks
- Misclassification if not confirmed by lab tests
Coding Notes
- Ensure lab confirmation is documented for acute cases.
B91 - Sequelae of poliomyelitis
Use for patients with long-term effects of polio, such as limb atrophy.
Applicable To
- Chronic effects of poliomyelitis
Excludes
- Acute poliomyelitis (A80.-)
Clinical Validation Requirements
- History of poliomyelitis
- Chronic muscle atrophy or weakness
Coding Notes
Document the specific sequelae for accurate coding.
G14 - Postpolio syndrome
Use when postpolio syndrome is diagnosed with new symptoms in a polio survivor.
Applicable To
- New onset of muscle weakness or fatigue in polio survivors
Excludes
- Sequelae of poliomyelitis (B91)
Clinical Validation Requirements
- History of poliomyelitis
- New muscle weakness or fatigue
- Exclusion of other causes
Coding Notes
Ensure documentation of new symptoms and exclusion of other causes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for immunization
Z23Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Polio to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A80.9.
Impact
Clinical: Leads to misdiagnosis and inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential denial of claims due to lack of evidence.
Mitigation Strategy
Ensure lab results are included in patient records., Verify documentation before coding.
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure acute cases are coded with A80.x series.
Impact
Failure to sequence codes correctly can lead to audit flags.
Mitigation Strategy
Train staff on proper sequencing rules and conduct regular audits.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Polio, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Polio
Use these documentation templates to ensure complete and accurate documentation for Polio. These templates include all required elements for proper coding and billing.
Acute Poliomyelitis Diagnosis
Specialty: NeurologyRequired Elements
- History of present illness
- Physical examination findings
- Laboratory test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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